Testicular Pain: When to Request Semen Analysis

excuse me?

Hello, Doctor Hsu.
I have been experiencing persistent pain in my right testicle.
I visited a nearby provincial hospital for an examination, and they tested my urine, which came back normal (they just didn't check my semen).
Can I proactively ask the doctor to check my semen? What should I pay attention to when getting a semen analysis? During the physical examination, the doctor mentioned that there was no inflammation in the testicle and prescribed medication for benign prostatic hyperplasia.
During the pain episodes, I notice that my penis sometimes discharges prostatic fluid.
Could this really be benign prostatic hyperplasia? I also experience frequent pain, and occasionally after masturbation, the pain is less severe.
Is there a connection between this and ejaculation?

Xiao Pi, 20~29 year old female. Ask Date: 2009/03/23

Dr. Xu Weikai reply Urology

Hello, you can proactively request a semen analysis, but it doesn't necessarily indicate there is a problem.
Testicular pain can have many causes that need to be explored: 1.
Local infections: such as orchitis, seminal vesiculitis, and prostatitis.
2.
Kidney stones: the referred pain may be felt in the penis and testicles.
3.
Neuromuscular pain, among others.
You can undergo urine and semen tests, ultrasound examinations (of the prostate, testicles, kidneys, etc.), and X-ray imaging to establish a definitive diagnosis.
If there are any unclear points, feel free to ask again, and we can discuss and research further.
Sincerely, Dr.
Hsu Wei-Kai, Director of Urology, Taitung Hospital, Department of Health, Executive Yuan.

Reply Date: 2009/03/23

More Info

Understanding testicular pain can be complex, as it may arise from various underlying conditions. In your case, you have already consulted a physician and undergone a urinalysis, which returned normal results. However, you are still experiencing persistent pain in the right testicle, and you are considering requesting a semen analysis.
Firstly, it is entirely appropriate for you to discuss your concerns with your physician and request a semen analysis if you feel it is warranted. Semen analysis can provide valuable information regarding sperm health, motility, and morphology, which can be important if there are concerns about fertility or if the pain is associated with reproductive issues. It is essential to communicate openly with your doctor about your symptoms and any concerns you may have regarding your sexual health.

When it comes to semen analysis, there are a few considerations to keep in mind:
1. Abstinence: It is generally recommended to abstain from ejaculation for 2 to 7 days before the test to ensure that the sample reflects your typical sperm production levels. This period allows for optimal sperm concentration and quality.

2. Sample Collection: The sample is usually collected through masturbation in a sterile container. If you have concerns about this method, discuss alternatives with your doctor, such as the use of a special condom during intercourse that can collect semen without spermicide.

3. Timing: Ensure that the sample is delivered to the laboratory as soon as possible after collection, ideally within one hour, to maintain the viability of the sperm.

Regarding your symptoms, the fact that you are experiencing pain that seems to lessen after ejaculation may suggest a connection to the prostate or seminal vesicles. The prostate can become inflamed or enlarged, leading to discomfort that may radiate to the testicles. This condition is often referred to as prostatitis or benign prostatic hyperplasia (BPH). The medication prescribed for BPH may help alleviate some of your symptoms, but it is crucial to monitor your pain levels and report any changes to your doctor.

The presence of pre-ejaculatory fluid (also known as pre-cum) during periods of pain could indicate that the prostate is still functioning normally, but it does not rule out the possibility of underlying issues. If the pain persists or worsens, further evaluation may be necessary, including imaging studies like an ultrasound or MRI to assess the structures in the pelvic region.

In summary, it is advisable to communicate your ongoing symptoms and concerns with your healthcare provider. Requesting a semen analysis is a reasonable step, especially if you are experiencing persistent testicular pain. Additionally, consider discussing the relationship between your symptoms and ejaculation, as well as any other factors that may contribute to your discomfort. Your health and well-being are paramount, and a thorough evaluation can help identify the cause of your symptoms and guide appropriate treatment.

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